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1 [Note: We recommend that you copy and paste the links below in your browser.] (Please See PCLC Disclaimer.) Prostate Anatomy Good general discussion of prostate anatomy from CDC: Urology Text book discussion of prostate gland anatomy, histology and function General overall technical discussion of the anatomy and function of the prostate gland: Prostate "capsule" anatomy. Link to cross sectional view of the prostate from the "top" or "sagittal plane" in medical terminology. Show NVB and very thin layer of tissue that represents the "capsule". Technical discussion of "gross" prostate gland anatomy from point of view of an imaging professional: 1

2 Nerves of the Prostate, Erectile Dysfunction and Sexual Impotence. Various images of the neurovascular bundle: client=safari&rls=en&source=lnms&tbm=isch&sa=x&ved=0ahukewjk5fp crofzahxqmvkkha2ka-uq_auicigb&biw=1279&bih=759 Very technical medical paper dealing with the neurovascular bundle of the prostate gland: Prostate Gland Zones and Related Information Prostate Gland Zones: Good general discussion of tumor characteristics in different anatomical zones: "Biologic differences between peripheral and transition zone prostate cancer" Discussion of central zone tumors and imaging: "Normal Central Zone of the Prostate and Central Zone Involvement by Prostate Cancer: Clinical and MR Imaging Implications" Benign Prostatic Hyperplasia (BPH): 2

3 General General discussion of prostate cancer diagnosis: Article: "Time to abandon the DRE?" Some (somewhat long) fundamental general summary of prostate cancer: American Cancer Society discussion of prostate cancer survival rates: PSA Definitions, Discussion What is PSA - prostate specific antigen - technical abstract PSA Testing: General discussion: U.S. Preventive Services Task Force Statement on PSA Testing: 3

4 One person's argument against PSA testing (presented for opposing point of view): More recent perspective on merits of PSA testing: Causes of elevated PSA besides prostate cancer: Very long and thorough and technical discussion of PSA screening and other diagnostic tests and procedures relating to prostate cancer: lt&selectedtitle=1~150&usage_type=default&display_rank=1 American Urological Association Best Practice Statement on PSA Testing: "PSA Testing for the Pretreatment Staging and Posttreatment Management of Prostate Cancer" The difference between PSA and "Free" PSA 4

5 Order your own lab tests on line without a formal physician visit: PCLC Note. Prescribing Antibiotics For Patients With Elevated PSA. A practice of prescribing antibiotics to patients who have elevated PSA results but negative DRE is a somewhat common practice, based on reports. The theory is that an elevated PSA in an asymptomatic patient with no other clinical indication of prostate cancer, may be caused by infection or inflammation and not prostate cancer and that administering an appropriate antibiotic may eliminate the infection, resulting in a potentially "normal" PSA result, thereby avoiding biopsy or other procedures. A number of published papers have concluded that studies indicate this practice is not supported by clinical study. For those interested in reviewing examples of such papers, links to them can generally be found with a google search such as: "antibiotics to lower PSA". However, prostate gland infection is known to be a cause of elevated PSA and antibiotics are routinely prescribed for such infections. In such a case, if a PSA spike were caused by infection which was resolved by treatment with antibiotics, it seems reasonable, on the basis of common sense, that one might question why this is not a reasonable step prior to biopsy. So, it is therefore, no doubt, often described as controversial for this divergence. For a patient in this situation, armed with this information, a treating physician is the right person to render advice as to the patient as to what to do and why. References:

6 What is SEER data? SEER is often referred to in clinical studies and in presentation of clinical data or other generalized data on prostate cancer. It is important to understand that SEER data is drawn from about 10% of the U.S. population, most likely for the sake of efficiency. Consequently, it may not be indicative of a cross section of the entire U.S. Disclaimer: The content provided herein is for informational purposes only. It is not designed to replace the professional medical advice you receive from your physician(s). Please consult your health care provider with any questions or concerns you may have regarding your condition. -End- 6